Visual recovery after macula-off retinal detachment

Ross, William H.

doi:10.1038/sj.eye.6700192

Cited by 121 publications

(104 citation statements)

References 28 publications

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“…[23][24][25] The results presented here demonstrate that there is a worse outcome following foveal involvement and therefore, as the rate of detachment cannot be accurately predicted, Table 2 The proportion of patients with 6/9 vision or better at follow-up and the relationship with variables that were significantly related to follow-up vision after multivariate analysis 6/9 or better vision with variable (%) surgeons need to perform prompt surgery for fovea on detachments to avoid progression and foveal detachment. 26 Surgeons have been reassured by publications that show no difference in visual recovery in patients with foveal off RRD and varying duration of symptoms in the first week [27][28][29][30][31] or first 10 days. 32 This has lead to Ross et al 29 suggesting that macular off RRD can wait for a scheduled operating list.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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Aims To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery. Methods Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed. Results In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r 2 ¼ 0.21, Po0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles ¼ 0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (Po0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), betterpresenting VA and fewer quadrants of detachment were associated with a better visual outcome (r 2 ¼ 0.26, Po0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P ¼ 0.013). Conclusions Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.

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Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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“…7 All our patients with a mean age of 58.7 ± 11.0 years at surgery were operated with the same technique within 7 days from macula-off RD onset. In our patients, mean post-operative BCVA slowly improved and reached the same BCVA recorded before RD onset in two out of six cases.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair

Rossetti

Doro

Manfre

et al. 2010

Eye

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Purpose To report the long-term sequential morphological and functional results in eyes with metamorphopsia after retinal detachment (RD) repair. Patients and methods In six eyes of six patients aged 58.7±11.0 years with metamorphopsia after successful buckling surgery for macula-off RD, best-corrected visual acuity (BCVA), fundus biomicroscopy, Amsler grid test, time-domain optical coherence tomography (TD-OCT) and central 121 microperimetry (MP-1) were performed at months 1, 3, 6, 12, and 18. At 5 to 6 years after surgery all patients underwent also spectral domain (SD)-OCT. Results Three eyes slowly recovered pre-RD BCVA. In the remaining three eyesFwith good final BCVAFthe interrupted junction line between photoreceptor cell inner and outer segments (IS/OS) was progressively less evident after RD surgery; and the external limiting membrane was preserved on SD-OCT examination. In all eyes post-operative metamorphopsia faded with time, but fully disappeared in 6 years only in two eyes without photoreceptor abnormalities. One of the two eyes with subretinal fluid up to 6 months and IS/OS disruption had central dense scotoma with relatively unstable fixation on MP-1 and persistent metamorphopsia. Macular sensitivity (MS) increased from 9.7 ± 7.1 at month 1 to 13.5 ± 5.6 dB at the final check, and was weakly (r ¼ 0.33) correlated with post-operative BCVA and OCT abnormalities. Conclusion Long-standing metamorphopsia can occur after successful macula-off RD repair even without detectable photoreceptor disruption on OCT. Post-operative BCVA recovery weakly correlates with increasing MS, and late restoration of the photoreceptor layer may be observed

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“…[26][27][28] Better preoperative VA, a shorter duration of detachment, fewer involved quadrants, younger age, and a lack of macular involvement with the detachment are important positive prognostic factors for VA. [29][30][31] In both groups of patients in our study (those with and those without PVR), the preoperative logMAR VA differed (Table 1) depending on whether the macula was involved. However, in both groups of patients no difference in the 8-month-postoperative logMAR was seen in patients with or without macular involvement.…”

Section: Discussionmentioning

confidence: 97%

Modelling postoperative visual acuity with and without proliferative vitreoretinopathy associated with primary rhegmatogenous retinal detachment

Roldán-Pallarés

Bravo-Llatas

Musa

et al. 2012

Eye

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Purpose To find models that will explain the variability in postoperative visual acuity (VA) (logarithmic: logMAR) associated with unilateral primary rhegmatogenous retinal detachment (RD). Methods This was a prospective clinical cohort study of 33 patients with proliferative vitreoretinopathy (PVR: PVRoC3) and 33 without PVR, all of whom were candidates for scleral buckling (SB) surgery. Central retinal artery (CRA) Doppler sonography parameters (peak systolic, end diastolic velocities and resistibility index) and intraocular pressure (IOP) were measured before SB. Immunoreactive endothelin-1 (IR-ET-1) levels in both plasma and subretinal fluid (SRF) were measured using a radioimmunoassay. Visual outcomes were analysed by stepwise multivariate linear regression. The preoperative parameters used in the analysis included RD duration, IOP, logMAR VA, CRA parameters, preoperative plasma levels and intraoperative levels of IR-ET-1 in the SRF. ConclusionsThe duration of RD and the levels of IR-ET-1 in the SRF appear to be the best explanatory variables in the models for 8-month-postoperative logMAR VA variability in RD patients. RD surgery should be performed as soon as possible to best preserve VA.

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Visual recovery after macula-off retinal detachment

Cited by 121 publications

References 28 publications

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair

Modelling postoperative visual acuity with and without proliferative vitreoretinopathy associated with primary rhegmatogenous retinal detachment

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